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HomeMy WebLinkAbout2013-01173 (Re-roof) CITY OF ORONO * 2 0 1 3 — P1 1 1 7 3 * � ` 2750 KELLEY PARKWAY DATE ISSUED: 1U0U2013 ORONO,MN 55356- , (952)249-4600 FAX: (952)249-4616 ADDRESS : 1270 ARBOR ST PIN : 10-117-23-31-0029 LEGAL DESC : CRYSTAL BAY MINNETONKA : LOT 000 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 11,780.85 NOTE: VALUATION OF PERMIT:$11,780.85 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 2448 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON TI�PROPERTY DURING'THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED TI�SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 221.25 VIKING CATASTROPHIC SERVICES STATE SURCHARGE(VALUATIOl� 5.89 307 GREENHILL LANE LONG LAKE,MN 55356- TOTAL 227.14 (952)681-9822 Minnesota State License#:RR667769 OWNER HANSON,TIMOTHY 1270 ARBOT ST WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. 7'his permit is for only the work described and does not grant permission for additional or relaLed work which requires separaYe permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.l'his permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspende for a period of 180 days at any time after work has commenced. The appli ant is res ible for assuring all required inspections are requested'n conf e with the State Building Code.This permit may be revoke �any e use. �, 11� I � / �� � 0� � �3 Applic 'ee Signa e Date Iss By Signature Date PARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. City of Orono ; - Bu�lding Permit Application for Maintenance / Replacement I Renovation (No structural expansion. Only windows, doors, sidin�, re-roof, etc.) �O� Mailing Address: Permit n�mber: �I3"'�GI� PO Box 66 0 Crystal Bay, MN 55323-0066 Date received: ���►`�-� Street Addr�ss: Receive �by: y� `�C'' 2750 Kelley Parkway Plan revi w fe lqkFSHO��,C' Orono,MN 55356 � / , Total Fe : � a 7 1 `�' Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information nlust be submitted. Incomplete applications will be returr�ed. (Please print) GENERAL INFORMATION: Job Site Address: i �'� n ►�2�,p � �-r� ,-E-� ..� �i Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home ❑Yes � No !f yes,a special event permit is required with Police Department and City Council approva/60 days prior to t e event Shuttle bus service will be required unless applicant demonstrates s�cient on-site parking is availab/e. Non permitted ev nts will not be allowed. CONTRACTOR/APP ICANT INFORMATION: Name: 1 �G�n G � 1-c���v��Pl�� V�'('�.�j State License# �� �,� 7� � q Expiration Qate: Lead Certification Number: Expiration pate: (for work on homes that were constructed prior to 1978 4 Phone: (cell) 9�Z � (�g 1 - ��0 D (office) I�Z ' �Z� - Z �y $ Mailing Address: 2�by (������.�,� � y� City: �N� Z�„�z ZIP: j��� Contact Person: ���tic� �,��,,���� Applicant is: ract / Homeowner (Clrcle One) Email and/or Fax: �o F '� �C�� , w� w PROPERTY OWNER INFORMATION: � Name: -�t vv� �wt ��,�r�--I I, Phone(day): ���� z � � �q q � Address: I Z7 o A���a- �i'i�� City: �,�.�7,�.�Q�- ZI P: ��3g I Email and/or Fax: PROJECT INFORMATION: Overall roject description: ���G Type of Project: Any earth ovement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MC review 8�permits: Minnehaha Cfeek Watershed District(MCWD) '�„Re-roof,asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage D�ephaven,MN 55391 ❑ Re-roof,other(speciiy) ❑ Siding ❑Other.(specify) PI'one: 952-471-0590 'ax: 952-471-0682 ❑Window(s) ww�v.minnehahacreek.or Estimated Construction Valuation of Project(excluding land) $ 31+ ��a D . � APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; � • Certifies that the information supplied is true and correct to the best of his/her knowledge. T e applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do o,the staff has no altemative but to reject it until it is complete; �I • Some or all of the information that you are asked to provide on this application is classifi�d by State law as either private or confidential. Private data is information which generally cannot be given to the public but caj� be given to the subject of the data. Confidential data is i ormation which generally cannot be given to either the public or the s�bject of the data. Our purpose and intended use of this in rm ' n is to annually update our records and records of other gover�mental agencies required by law. If ou refuse to su I th i f ,af n,the a lication ma not be issued. I Applicant's Signature: Date: �I ► � �, . Owner's Signature: Date: Last Updated:03/06/2013 � � ,j I'4. .a1,Tr�'�y'^ ` . µ ___. __ � . ..: .. . _~ ; . ., :__.. __•_' __ . _ ' . -_..-.; ._ . _' _ " . _ �, _ - � _�� • . A_a�.L ' ',lW •'• .. , . . .� . • . . . .. . , - - C ��� �`�'�..�V•� .- .��ALY;N� H. HEDLUND�.� _ . ., . . , : . . •.' �' I k r• . , , . . . �. . �618 Owilook Lak�Grd� , ,�;; ��LiM�u►v�y°� G � Civll E � , ' �. . . _ � , - , _ `;' �'` noima BloorninVtoe!.Min�wota b5437 .. . . a,Y� � d , . . . _ , . , ., � � � . . : " -,.• 888-2090 • `. . . � . '� st(rv ` • _ . . . . _ , ��- - � - . . ar�.s�.�'ert� �cate , � g_ „_� f' . ,.� .;. . �� . . . � . : � � . . - e . , . . . .. _ . � �. . : � - :���,,.*�,�.,, _ � � . - � . � � . . . ;- �.. : - � � � . - , �oe rro. , � . . . f . � Sl�vE1r l�OR� Jahn Worre • � ; '� !"^�!-��► �„ ; . ;a ;t�;!' !� . . • . : DESCRI� �S� Lota 9. an� 10, H1ock 1, CRYSTAL B�Y MINNETO - � ' ' ' ''_ � � ', . ', � . City �of Orono, Hennep�n County, Minhesota, d� P . 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Cali for th�next Fnsp�ction 24 hours in advaru�. (952) 249-4600 OwnerfContractor on site- inspector: � /.�-� _ White CopyRnsp�toPs Flle Canerp CopylSfte NoUee